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Document Typology: Research
Methodology addressed by the publication:International Classification of Functioning, Disability and Health
Title of document: The international classification of functioning disability and health, version for children and youth as a road-map for projecting and programming rehabilitation in a neuropaediatric hospital unit
Name of author(s): Andrea Martinuzzi, MD, PhD1, Annamaria Salghetti, MD1, Silvana Betto, PT1, Emanuela
Name of publisher: J Rehabil Med 2010: 42: 49-55
Language of the publication: English
Language of the review: English
Objective: To test the impact of introducing a format based on the International Classification of Functioning Disability and Health, version for children and youth (ICF-CY) as a road-map for in-hospital paediatric neuro-rehabilitation on target definition, intra-team communication and workload as perceived by involved professionals.
Design: Single-centre pilot testing with impact assessment.
Patients: Team members of a tertiary care paediatric neuro-rehabilitation unit included 15 consecutive patients with severe neurological conditions.
Methods: An ICF-CY based format for rehabilitation projection and programming was constructed and tested for 12 months. The format comprises 3 sections: project, programme, and follow-up. Impact on the rehabilitation team was assessed with a questionnaire.
Results: All cases were described according to their specific needs with appropriate ICF-CY codes, and the interventions were linked to needs and targets. ICF-CY was judged an efficient tool in providing a road-map for rehabilitation in this setting, although concern was voiced about timing and workload.
Conclusion: ICF-CY may work as a road-map for in-hospital paediatric neuro-rehabilitation. Its implementation results in perceived improvements in the process. Training requirements and accurate evaluation of timing, workload and organizational context are critical issues that should be addressed before results from the present experience are generalized.
Reviewer's comments on the document:
This paper describes the first attempt to implement the new ICF-CY in a clinical setting. This experiment is important for 2 reasons: it represents the first direct clinical utilization of this new classification, testing its efficiency in describing children and adolescents with complex disabilities; and it demonstrates the feasibility of ICF in-hospital implementation, by embedding its conceptual framework in goal definition, process analysis, and outcome evaluation. The setting in which the study was held is a small (40-bed) neuro-rehabilitation unit specifically devoted to children and adolescents, where all professionals were already familiar with team-work, and this might have eased the experience. Nevertheless, the recognition of the added value brought by the implementation of the new ICF-CY-based format, which emerged from the questionnaires, accounts for some difficulties in communication and goal-setting, which the use of ICF-CY helped to overcome (to see the article).

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